Comparison of Four Dental Pulp-Capping Agents by Cone-Beam Computed Tomography and Histological Techniques—A Split-Mouth Design Ex Vivo Study

Abstract

Dental pulp-capping is done to preserve vital teeth when the pulp is exposed due to caries, trauma or instrumentation. Various materials are used as pulp-capping agents. The introduction of newer materials requires scientific studies to assess their clinical efficacy. The study was designed as a split-mouth randomized analysis of four pulp-capping agents (calcium hydroxide, mineral trioxide aggregate (MTA), Biodentine and EndoSequence root repair material (ERRM)). Based on selection criteria, 15 orthodontic patients requiring the extraction of four premolars (60 teeth total) were included in the study. After pulp-capping, the teeth were extracted after 8 weeks. We analyzed the extracted teeth using cone-beam computed tomography (CBCT) and histological sections to determine the quality of the dentinal bridge and the pulpal response. Ordinal scores were given based on the completeness of the dentinal bridge, the type of bridge and the degree of pulpal inflammation. Results were analyzed using a Kruskal–Wallis test (p < 0.05) with post hoc Conover values being used when applicable. All four pulp-capping materials elicited dentinal bridge formation (60/60). MTA had the highest scores (10/15) in dentinal bridge formation followed by ERRM (8/15). Both materials showed more samples with complete dentinal bridges (9/15 each) and a favorable pulpal response (15/15). Teeth capped with calcium hydroxide showed more cases of incomplete bridge formation (9/15) and pulpal inflammation. These differences in dentinal bridge formation and pulpal inflammation were statistically significant (p 0.001 and p 0.00005, respectively), with post hoc tests revealing no significant differences between MTA and ERRM (p 0.49 and p 0.71, respectively). MTA and ERRM performed better than the other pulp-capping materials but did not differ significantly from each other. The individual preference for a pulp-capping material may be based on clinical efficacy and handling characteristics.

An Update on Nickel-Titanium Rotary Instruments in Endodontics: Mechanical Characteristics, Testing and Future Perspective—An Overview

“…In fact, during the evaluation of the performance of NiTi rotary instruments the shaping ability should be considered. As stated by several Authors, the shaping ability could be considered as a macro-group of characteristics that comprises centering ability, canal transportation, difference between canal volume before and after therapy and the ratio between touched an untouched dentinal area [ 90 , 91 , 92 , 93 , 94 , 95 ].…”

Optimization of X-ray Investigations in Dentistry Using Optical Coherence Tomography

“…Today, cutting-edge X-ray dental units have digital sensors capable of providing high-quality images [ 4 , 5 , 6 , 7 , 8 ]. The difference between units available on the market is made by the characteristics of the sensors, such as spatial resolution or contrast.…”

The Influence of New Bioactive Materials on Pulp–Dentin Complex Regeneration in the Assessment of Cone Bone Computed Tomography (CBCT) and Computed Micro-Tomography (Micro-CT) from a Present and Future Perspective—A Systematic Review

“…The studies eligible for the analysis were divided into two groups: non-randomized studies ( n = 11) [ 14 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ] and randomized studies ( n = 3) [ 48 , 49 , 50 ]. All research articles under analysis were in vivo studies.…”

“…Consequently, at a subsequent phase of selection, the research papers which did not meet the criteria were excluded by hand and the duplicates were eliminated. The results were thoroughly selected considering the inclusion criteria, and 5 research papers were eventually qualified to the analysis [ 38 , 39 , 40 , 48 , 50 ]. All studies ( n = 5) were conducted on human teeth and were approved by the relevant Bioethics Committees.…”